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Expert Point of View: Elizabeth Mittendorf, MD

“This study confirms previously published racial disparities in access to care, but factors that drive these disparities have not been elucidated,” stated Elizabeth Mittendorf, MD, Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center, Houston. The study was...

hematologic malignancies
lymphoma

Bendamustine/Rituximab Noninferior to Standard Chemotherapy for Advanced Indolent Non-Hodgkin and Mantle Cell Lymphomas 

The combination of bendamustine (Treanda) and rituximab (Rituxan), or BR, was found to be noninferior to commonly used chemotherapy with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-CVP (rituximab plus cyclophosphamide, vincristine, and prednisone) in...

hematologic malignancies
issues in oncology

Pomalidomide in Previously Treated Multiple Myeloma 

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On February 8, 2013, the immunomodulatory agent...

solid tumors
gastroesophageal cancer

Second-line Docetaxel Improves Esophageal and Gastric Cancer Survival 

A phase III study from the United Kingdom has shown that second-line treatment with docetaxel improves overall survival of patients with advanced esophagogastric cancer.1 The strategy has already been widely adopted, but COUGAR-02 is the first study to provide definitive evidence of a survival...

head and neck cancer

Two Studies Focus on Treatment Strategies for Preserving the Larynx While Increasing Survival

Two recent studies in the Journal of Clinical Oncology focused on treatment strategies to preserve the larynx while increasing survival of patients with cancer of larynx. RTOG 91-11 Ten-year results from the Radiation Therapy Oncology Group (RTOG) 91-11 trial found that both chemotherapy regimens...

survivorship

Number of Cancer Survivors Expected to Increase to 18 Million by 2022

The American Association for Cancer Research recently released its second Annual Report on Cancer Survivorship in the United States. The report shows that as of January 2012, there were approximately 13.7 million cancer survivors in the United States, a number that is expected to rise by 31% to 18...

Radiation, Still Misunderstood after All These Years 

Over the past few decades, radiation therapies have rapidly advanced, due, in large part, to an increasing technologic armamentarium. Among modern science’s most impressive machines, for example, 220-ton particle accelerators can generate near-light-speed beams of protons, with sniper-like...

breast cancer

CDC Reports Racial Disparity in Breast Cancer Mortality  

Breast cancer deaths have declined over the past 2 decades, with approximately half of the decrease estimated to be due to advances in early detection and treatment. However, not all racial groups have benefited equally from these advances. A recent report from the Centers for Disease Control and...

health-care policy
legislation

AACR Briefs Congressional Staffers on Importance of Continued Funding for Research 

As we all now know, the start of the sequestration prescribed by the Budget Control Act of 2011 was delayed until March 1, 2013, by the American Taxpayer Relief Act of 2012. With Congress unable to strike a deal, the mandatory reductions in Federal spending were triggered on March 1. Those...

colorectal cancer

CT Colonography Reconsidered

The parallel SIGGAR trials recently published in Lancet add to the growing body of literature regarding the utility of computed tomographic (CT) colonography in the detection of colorectal polyps and cancers. These papers reinforce the results seen in other large multicenter trials1-3 and echo the...

colorectal cancer

SIGGAR Trials Compare CT Colonography vs Barium Enema and Colonoscopy in Evaluation for Colon Cancer 

The companion UK Special Interest Group in Gastrointestinal and Abdominal Radiology (SIGGAR) trials compared computed tomographic (CT) colonography with barium enema and colonoscopy in patients with symptoms suggestive of colon cancer. As recently reported by the SIGGAR investigators in The...

breast cancer

Ado-Trastuzumab Emtansine in Metastatic Breast Cancer 

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.  Indication On February 22, 2013, ado-trastuzumab emtansine...

bladder cancer

Clinical-Pathologic Stage Discrepancy High in Patients with Bladder Cancer Undergoing Surgery 

About 48% of all patients with bladder cancer undergoing radical cystectomy have a discrepancy between their clinical stage and pathologic stage, according to the largest study to date to examine this issue. Upstaging after surgery is associated with reduced survival, while downstaging after...

kidney cancer
prostate cancer

New Findings in Prostate and Kidney Cancers Clarify the Roles of Abiraterone, Finasteride, Bevacizumab, and Surveillance 

Attendees at the 2013 Genitourinary Cancers Symposium in Orlando, Florida, were brought up to date with the latest news on cancers of the prostate, testes, bladder, and kidney. Below are selected highlights from the meeting describing findings of noteworthy abstracts to extend our regular news...

survivorship

Sexual Health after Cancer: Communicating with Your Patients 

Studies show virtually all cancer survivors will experience some form of sexual dysfunction following a cancer diagnosis and treatment. Yet few cancer survivors seek help for physical problems they may be experiencing, such as vaginal dryness, dyspareunia, chemically induced menopause, reduced...

breast cancer

Progression-free Survival in HER2-positive Metastatic Breast Cancer Improved with T-DM1 

First-line treatment with ado-trastuzumab emtansine (T-DM1) “provided a significant improvement” in progression-free survival when compared to trastuzumab (Herceptin) plus docetaxel in a randomized phase II study among patients with HER2-positive metastatic or recurrent locally advanced breast...

solid tumors
colorectal cancer

Benefit of Continued Antiangiogenic Treatment with Bevacizumab after Progression in Metastatic Colorectal Cancer 

As reported recently in Lancet Oncology by Jaafar Bennouna, MD, of Institut de Cancérologie de l’Ouest, Nantes, France, and colleagues, the phase III ML18147 trial showed a survival benefit with continued bevacizumab (Avastin) treatment after first progression in metastatic colorectal cancer.1 The...

skin cancer

Sentinel Node Biopsy in Melanoma: Essential or Optional? 

Is sentinel node biopsy in melanoma an essential component of care? Despite a large multinational trial and recently published or updated guidelines, the question is still a thorny one according to experts who debated the issue at the recent meeting of the Society of Surgical Oncology in...

SIDEBAR: The Ethical Imperative of Clinical Equipoise 

In her editorial about the RESONATE trial (page 1), Dr. O’Brien raises the issue of equipoise in this phase III clinical trial that compares the efficacy of ibrutinib and ofatumumab (Arzerra) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who are not appropriate...

gynecologic cancers

Most Women with Ovarian Cancer Do Not Get Guideline-specified Treatment Linked to Survival Benefits 

Most women with ovarian cancer are not receiving adequate treatment, as specified in National Comprehensive Cancer Network (NCCN) Guidelines,1 and as a result are being deprived of the survival benefits correlated with guideline-recommended treatment, according to a study presented at the Society...

lung cancer

HDAC Inhibition Circumvents EGFR Tyrosine Kinase Inhibitor Resistance Due to BIM Polymorphism 

Upregulation of BIM (BCL2L11), a proapoptotic member of the BCL2 protein family, is required for induction of apoptosis by EGFR tyrosine kinase inhibitors in EGFR-mutant forms of non–small cell lung cancer (NSCLC). A BIM deletion polymorphism occurs naturally in approximately 13% of East Asian...

C-Reactive Protein Downregulates TRAIL, a Cytokine with Key Role in Cancer Immune Surveillance 

C-reactive protein is a biomarker of acute and chronic inflammation that is frequently elevated in patients with cancer. In a study reported in Clinical Cancer Research, Secchiero and colleagues found that increased levels of C-reactive protein were associated with downregulation of TRAIL, a...

breast cancer

Living with the Fear of Cancer 

After a friend was diagnosed with breast cancer, I became so worried it would happen to me, I decided to perform regular breast self-exams so I could familiarize myself with the normal feel of my breasts, and quickly spot any changes. My friend’s diagnosis scared me, and that fear probably saved my ...

leukemia

Drug Approvals in Acute Myeloid Leukemia: Can We Do Better? 

Forty years ago, President Richard Nixon announced a “war on cancer.” Some of that war’s first battles were won in the field of acute myeloid leukemia (AML) with two agents, cytarabine and daunorubicin, receiving U.S. Food and Drug Administration (FDA) approval based on their ability to produce...

gynecologic cancers

Women with Lynch Syndrome and Endometrial Cancer Are at Increased Risk of Other Cancers 

Lynch syndrome is an autosomal dominantly inherited disorder due to germline mutations in DNA mismatch repair genes. Mismatch repair mutation carriers are at increased risk of several cancers, with endometrial cancer being one of the most commonly diagnosed cancers in women with Lynch syndrome. In...

gynecologic cancers

Combinatorial Immunologic Approach Yields Benefit in Preliminary Study of Recurrent Ovarian Cancer

A two-step immunologic approach that includes a personalized dendritic cell vaccine for each patient followed by adoptive T-cell therapy holds promise for the treatment of recurrent ovarian cancer, according to results of two consecutive phase I studies presented at the American Association for...

breast cancer

Novel Regimen Produces High Pathologic Complete Response Rates in Triple-negative Breast Cancer 

Interim results from a small neoadjuvant study of patients with triple-negative breast cancer has found high rates of pathologic complete response with the combination of nab-paclitaxel (Abraxane), carboplatin, and bevacizumab (Avastin).1 The study was presented at the 18th Annual Conference of the ...

Personal Testimonial: CAR-modified T Cells in Adults 

Twelve adults with chronic lymphocytic leukemia (CLL) have been treated with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy at the University of Pennsylvania in Philadelphia by Carl June, MD, Richard W. Vague Professor in Immunotherapy, and colleagues. These were all end-stage...

hematologic malignancies
lymphoma

Autologous Stem Cell Transplant Improves Survival in Transformed Follicular Lymphoma  

As reported by the Canadian Blood and Marrow Transplant Group in Journal of Clinical Oncology,1 patients with transformed follicular lymphoma receiving autologous transplantation have improved survival outcomes compared with patients receiving rituximab (Rituxan)-containing chemotherapy alone....

issues in oncology

Women in Oncology: Trending in the Right Direction 

According to ASCO President ­Sandra M. Swain, MD, FACP, an important part of her Presidential theme, “Building Bridges to Conquer Cancer,” is finding creative ways to ensure that we have enough oncologists to care for our burgeoning cancer patient population. Adding more women to the oncology...

SIDEBAR: Critical Information on Radiation's Heart Effects  

The paper by Darby et al provides extremely important information on quantitative estimates of the effect of radiotherapy on coronary events in women with breast cancer.1 The authors have determined a direct relationship between radiation dose and effects on the heart and provide strong evidence...

Factors Increasing Risk of Death from Breast Cancer Identified  

Several studies presented at the Annual Meeting of the American Association for Cancer Research in Washington, DC, focused on factors associated with breast cancer mortality. One study found that older women with longer intervals between mammograms had a higher likelihood of dying of breast cancer. ...

lung cancer

The Tissue Is the Issue: Choosing Therapy for Lung Cancer 

The new guidelines from the College of American Pathologists, International Association for the Study of Lung Cancer, and Association for Molecular Pathology (CAP/IASLC/AMP) are a significant step toward personalized therapy of patients with lung cancer. More than 226,000 new patients per year are...

lung cancer

New Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitor Treatment 

A new guideline for molecular testing to select lung cancer patients for treatment with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors has been jointly developed by the College of American Pathologists, International Association for the Study ...

hepatobiliary cancer
lung cancer

Interventional Radiologists Report Novel Approaches for Metastatic Lesions  

For the treatment of metastases to the liver and the lung, interventional radiologists reported early success with two novel approaches at the Society of Interventional Radiology (SIR) 38th Annual Scientific Meeting, held recently in New Orleans. Cryoablation of Lung Tumors For patients with...

health-care policy
legislation

Sequestration's Impact on Cancer Care  

On March 1, the deficit-budget mechanism known as sequestration took effect, triggering $85 billion in across-the-board cuts to most federal agencies over the remaining 7 months in fiscal year 2013. The total federal deficit reduction budget under the Budget Control Act of 2011 calls for $1.2...

solid tumors
leukemia

Profound and Rapid Molecular Remission with CD19-targeted T Cells in Relapsed B-cell ALL 

As was recently reported in Science Translational Medicine, Renier J. Brentjens, MD, and colleagues at Memorial Sloan-Kettering Cancer Center, New York, found that profound molecular remission was rapidly induced in patients with relapsed B-cell acute lymphoblastic leukemia (ALL) using autologous T ...

American Cancer Society Marks 100th Year Anniversary 

The American Cancer Society announced the Society’s 100th birthday on May 22, 2013. Founded 100 years ago by 15 prominent physicians and business leaders in New York, the American Cancer Society, first known as the American Society for the Control of Cancer, launched the fight against a disease...

integrative oncology

Ginger

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

solid tumors

HIV Infection Does Not Adversely Affect Outcomes of Liver Transplantation for Hepatocellular Carcinoma

Liver transplantation for hepatocellular carcinoma is feasible for HIV-infected patients, with no differences in post-transplant survival or hepatocellular carcinoma recurrence rates compared with liver transplantation for hepatocellular carcinoma in HIV-uninfected patients. The study, published in ...

solid tumors
kidney cancer

No Difference in Overall Survival with Axitinib or Sorafenib in Second-line Treatment for Advanced Renal Cell Carcinoma 

The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma showed significantly prolonged independent radiology committee–assessed progression-free survival with axitinib treatment (hazard ratio [HR] = 0.665, P ...

Expert Point of View: Giulia Veronesi, MD

The study discussant, Giulia Veronesi, MD, of the Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy, said that diagnostic algorithms aim to strike a balance between a too-invasive workup that exposes screened persons to useless invasive procedures and overtreatment, and...

Expert Point of View: Elisabeth Quoix, MD

The study discussant, Elisabeth Quoix, MD, of the University Hospitals of Strasbourg, France, said that this meta-analysis confirmed that platinum-based doublets remain the standard treatment in this setting. Benefit of platinum-based doublets over non–platinum-based chemotherapy is essentially due ...

lung cancer
issues in oncology

Simultaneous EGFR Mutations and HER2 Gene Amplifications in Large Series of Patients with Non–Small Cell Lung Cancer 

In a molecular profile analysis of 2,271 cases of non–small cell lung cancer (NSCLC), EGFR was mutated in 12% and KRAS in 32% of cases. HER2 gene amplification was confirmed as a rare event in NSCLC (4%). Coexistence of HER2 gene amplification and EGFR mutation was identified in three cases, while...

hematologic malignancies
leukemia

Postinduction Dexamethasone and Individualized Dosing of Asparaginase Improve Outcome in Pediatric ALL 

Findings from the Dana-Farber Cancer Institute ALL Consortium Protocol 00-01, recently reported by Lynda M. Vrooman, MD, Dana-Farber Cancer Institute, and colleagues in Journal of Clinical Oncology, indicate that postinduction dexamethasone and individualized dosing of Escherichia coli–derived...

breast cancer

Double the Mastectomy, Double the Complications 

A retrospective analysis of a large surgical database has documented that bilateral mastectomy is associated with a doubling in complication rates, compared with unilateral mastectomy. Researchers reported the findings at the 14th Annual Meeting of the American Society of Breast Surgeons in...

supportive care

Once-daily Moxifloxacin for Low-risk Patients with Febrile Neutropenia 

Once-daily oral moxifloxacin works at least as well as twice-daily oral ciprofloxacin plus amoxicillin–clavulanic acid when it comes to treating febrile neutropenia in patients who are at low risk for complications, according to a randomized, double-blind trial reported in the Journal of Clinical...

palliative care

Death with Dignity Program at Seattle Cancer Care Alliance 

After passage of the Washington Death with Dignity Act in November 2008, the Seattle Cancer Care Alliance—the site of outpatient care for patients with cancer from Fred Hutchinson–University of Washington Cancer Consortium—developed a Death with Dignity program. The program is adapted from existing ...

solid tumors

Impressive Results Shown for Immune Checkpoint Inhibitors: Anti-PD1 and Anti-PD-L1 Antibodies 

Antibody-mediated blockade of the programmed death 1 protein (PD-1) and its ligand (PD-L1) resulted in potent and durable tumor regression and prolonged stabilization of disease in patients with advanced solid tumors, according to early data on these drugs presented at the 2013 ASCO Annual Meeting. ...

After a Distinguished Career, Trailblazing Swiss Oncologist Remains Devoted to Addressing the Global Cancer Challenge 

Switzerland, a landlocked country with a population about that of New York City, has four geographic regions, each with its own official language. Internationally regarded lymphoma and breast cancer expert, Franco Cavalli, MD, FRCP, was born and raised in Locarno, a town in the Italian region of...

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